| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $104.74 | $104.74 | $104.74 | |
Medica
| Facility | $100.00 | $100.00 | $100.00 | |
Medica
| Professional | $134.12 | $134.12 | $134.12 |
Heavy-duty shock absorber for heavy-duty or extra heavy-duty manual wheelchair, each
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $104.74 | $104.74 | $104.74 | |
Medica
| Facility | $100.00 | $100.00 | $100.00 | |
Medica
| Professional | $134.12 | $134.12 | $134.12 |